Periodontal Procedures

Surgical Periodontal Procedures

Sometimes a periodontist may need to perform a surgical procedure to treat periodontal disease and any damage it may have caused. Because they receive three years of specialized training following dental school, periodontists are experts in performing gum surgery and are trained in administering the appropriate comfort measures such as sedation or anesthesia during treatment. 

Dental Extraction (also known as tooth pulling) 

An extraction is the removal of teeth from the dental alveolus (socket). Extractions are performed for a wide variety of reasons, but most commonly to remove teeth which have become unrestorable through tooth decay, periodontal disease, or dental trauma, especially when they are associated with toothache.  

Bone Graft surgery 

Bone grafting is used to prepare a site for dental implants. A bone graft adds volume and density to your jaw in areas where bone loss has occurred.  In this case, new bone must be added to create a secure site for the dental implant.  

Gum Graft Surgery 

Exposed tooth roots are the result of gum recession. Gum graft surgery will cover the exposed root and help prevent additional recession and root cavities. 

During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. Gum graft surgery can be performed on one tooth or multiple teeth and may help reduce tooth sensitivity and improve the aesthetics of your smile. 

Dental Crown Lengthening 

Some individuals may have a “gummy” smile because the teeth appear short. In fact, the teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure. 

During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile. 

Your dentist or periodontist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored. 

Periodontal Pocket Procedures 

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone are destroyed, forming “pockets” around the teeth. 

Over time, these pockets become deeper, providing a larger space for bacteria to live accumulate and advance under the gum tissue. These pockets can result in bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted. 

During a periodontal pocket procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone. 

Non-Surgical Treatments

Depending on your unique case, you may be a candidate for non-surgical periodontal treatment. However, these procedures do have limitations. When non-surgical treatment does not achieve optimal periodontal health, your periodontist may recommend gum surgery. 

Scaling and Root Planing 

In scaling and root planing, your periodontist will perform a deep cleaning of your tooth root surfaces. First, your periodontist will scale beneath the gumline to remove plaque and other bacterial toxins from periodontal pockets. Root planing allows your periodontist to smooth the tooth root to prevent future plaque or toxins from adhering. 

Many patients do not require additional treatment after scaling and root planing. However, the majority of patients will require ongoing maintenance therapy to sustain periodontal health. 

Laser Treatment 

Lasers can be used to treat periodontal disease. Current controlled studies have shown that similar results have been found with laser treatment compared to specific other non-surgical treatment options, including scaling and root planing alone. 

Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. However, damage to periodontal tissues can result if a laser with an inappropriate wavelength and/or power level is used during a periodontal procedure.